Value of glycolic acid analysis in ethylene glycol poisoning: A clinical case report and systematic review of the literature. (September 2018)

• Record Type: Journal Article
• Authors: Tuero, Gaspar; González, Jesús; Sahuquillo, Laura; Freixa, Anna; Gomila, Isabel; Elorza, Miguel Ángel; Barceló, Bernardino
• Is Part Of: Forensic science international. Volume 290(2018)
• Page Start: e9
• Page End: e14
• Publication Date: 2018-09
• Subjects: Ethylene glycol -- Glycolic acid -- Intoxication -- Diagnosis -- Prognosis; Medical jurisprudence -- Periodicals; Chemistry, Forensic -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Chimie légale -- Périodiques; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; Chemistry, Forensic; Medical jurisprudence; Electronic journals; Periodicals; Electronic journals; 614.1
• DOI: 10.1016/j.forsciint.2018.07.007
• Languages: English
• ISSNs: 0379-0738

Abstract

Highlights: In ethylene glycol (EG) poisoning, analysis of glycolic acid (GA) is advisable. Serum GA levels (cut-off: 990.5 mg/L) predict mortality risk. GA analysis is especially useful to identify late presentations. In our case, urine GA allowed us to confirm the diagnosis. Abstract: Objective: To evaluate the clinical utility of glycolic acid (GA) determination in the diagnosis and prognosis of ethylene glycol (EG) intoxications. Method: Systematic review of serum and/or urine GA concentrations available in the literature in cases of EG poisoning. Present a clinical case in which the determination of the GA was decisive. Results: In total, 137 patients were included. Serum GA concentrations (but not EG) of patients who survive are different from those who die. The optimal cut-off of serum GA to predict mortality was 990.5 mg/L (sensitivity 85.2%, specificity 54.3%) with an Odds Ratio of 6.838 (2.868–16.302). In our clinical case, serum EG was negative; however, urine GA was positive (1230.7 mg/L). Conclusions: In all suspected cases of EG poisoning, it is advisable to carry out the simultaneous analysis of EG and GA.